Next to the motor symptoms the sensory are the most important. Pain not infrequently occurs after the recovery of consciousness in the affected limb; it is apt to be sharp, severe, darting and neuralgic in character. This may last at intervals for some days, a dull ache occurring at first between the intermissions. It disappears of itself in time without lasting effects.
Hyperæsthesia may exist at first. Should this continue, or if anæsthesia not due to secondary traumatic conditions should appear later, we should be inclined to place these symptoms in the third class.
Of other symptoms occurring in accidents from currents of high potential, those which seem to be due to the direct action of the electricity are not serious. Buzzing in the ears and a metallic taste in the mouth often occur at the very beginning before the consciousness is involved. Nausea and vomiting frequently occur later. There is often considerable dizziness and vertigo. Patients sometimes complain of sensations as of an electric shock running through the body which occur without cause some hours or even days after the real shock. Some of these sensations are certainly to be reckoned under the mental or psychical symptoms. Susceptibility to the effects of electricity, of lightning, and of thunder-storms, though undoubtedly in many cases psychical, has probably in some cases an actual foundation. This is certainly the case in lightning stroke. On the other hand, in the large majority of cases of electric accidents no such result follows, and in many we are expressly told that such a result was looked for but not found.
The temperature, as affected by the electricity alone and not as secondary result of injuries, is not always easy to determine. It seems to be in most cases lowered at first, being in that of Moyer 97.5° and in that of Robert 97°. Later it may rise to a certain extent, usually to not more than 101°, but here again the influence of traumata is difficult to separate.
The pulse may be full and soft or weak and compressible. It is frequently very feeble, sometimes almost imperceptible, and often rapid. It is apt to remain rapid and somewhat soft for days in severe cases.
The respiration is at first rapid in severe cases unless the shock be so great as to cause its cessation. This rapidity remains for a varying period and then disappears.
As a typical case of the results of shock from an electric wire, we will mention the one reported by Dr. F. W. Jackson. The patient, a man twenty-two years old, came in contact with a live electric-light wire, touching it with his hands. He was thrown a distance of about ten feet and then back again, “swinging back and forth two or three times.” His hands were in contact with the wire about three minutes, when the current broke and he fell to the ground unconscious. Was seen two hours later by physician. Temperature 100°; pulse 100, strong and bounding; pupils dilated; headache; nervous and irritable; reflexes increased. The headache was accompanied by insomnia which continued for three days, after which it disappeared, and he resumed work apparently none the worse for his accident. The palmar surfaces of both hands and the anterior surfaces of the forearms were blackened from the tips of the fingers to a point midway between the wrists and the elbows, and these parts were exceedingly sensitive to the touch. The least irritation of the muscles would cause them to contract violently. This condition ceased on the second day. The current was from a fifty-light arc circuit of about 2,100 volts; 6.8 amperes. The accident took place out-of-doors on a very rainy night. The amount of electricity which the patient received was, as in all such cases, very uncertain.
FATAL CURRENT.
The amount of current which will produce a fatal effect varies with the character of the current and with the points of contact. Currents passing through the head or those which affect the pneumogastric nerves are much more dangerous than others of the same character and equal strength passing through one extremity, for example.
The same current will, of course, also produce different effects, according to the facility of its conduction into and through the body, and this depends again on the completeness of the contact and whether the body or the portion thereof concerned enters directly into the circuit or only forms, as it were, a partial conductor and diverts a certain portion only of the current to itself. Again, the condition of the epidermis, whether dry or wet, and the position of the person in relation to good conductors, metallic or otherwise, has much effect.